Individual
DR. NANCY BROUS-DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1380 COWELL FARM RD, WASHINGTON, NC 27889-3431
(252) 946-2101
Mailing address
1380 COWELL FARM RD, WASHINGTON, NC 27889-3431
(252) 946-2101
(252) 946-9071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200301208
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508821315
NPI
NC
Enumeration date
04/18/2006
Last updated
04/26/2022
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